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Vermont rates for HCPCS A4375

Ostomy pouch, drainable, with faceplate attached, plastic, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $15.49 / $18.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $15.85 / $16.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $13.49 / $15.85
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.62 / $23.44 / $23.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.33 / $9.33 / $10.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $14.45 / $50.12